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| Analysis of the Correlation between Postoperative CT Cistern Grading and Non-invasive Intracranial Pressure and Cerebrospinal Fluid Lactate in Patients with Severe Traumatic Brain Injury |
| SUN Junfeng, GAO Qiang, CHANG Puying |
| The People's Hospital of Baoji,Baoji Shaanxi 721000 |
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Abstract 【Objective】To explore the relationship between postoperative CT cistern grading,non-invasive intracranial pressure(NICP),and cerebrospinal fluid lactate in patients with severe head injury.【Methods】A total of 128 patients with severe traumatic brain injury admitted to Baoji People's Hospital from October 2019 to October 2022 were selected and divided into grade Ⅰ group(n=61),grade Ⅱ group(n=46),and grade Ⅲ group(n=21) based on the preoperative circumferential pool grading of the patient's head CT. We compared the differences in intracranial pressure and cerebrospinal fluid lactate levels among patients with different grades,and used Spearman correlation analysis to investigate the correlation between head CT ring pool grading and non-invasive intracranial pressure and cerebrospinal fluid lactate levels. 【Results】 There was a statistically significant difference in CT annulus grading between patients with different preoperative CT annulus grading at 4 hours and 72 hours after surgery(P<0.001); The CT annular pool grading of patients in the Class Ⅱ and Ⅲ groups showed a decreasing trend at 4 hours and 72 hours after surgery(both P<0.05). At 4 hours and 72 hours after surgery,the NICP of patients with different ring pool grades was lower than before surgery(P<0.05); At 4 hours and 72 hours after surgery,the NICP levels in the grade Ⅱ and Ⅲ groups were lower than those in the grade Ⅰ group,while the NICP levels in the grade Ⅲ group were lower than those in the grade Ⅱ group(P<0.05). At 4 hours and 72 hours after surgery,the cerebrospinal fluid lactate levels in patients with different cistern grading were lower than before surgery(P<0.05); At 4 hours and 72 hours after surgery,the cerebrospinal fluid lactate levels in the grade Ⅱ and Ⅲ groups were lower than those in the grade Ⅰ group(P<0.05). There was a negative correlation between the grading of the cranial CT annulus and postoperative NICP(P<0.05); There was a negative correlation between preoperative CT cistern grading and cerebrospinal fluid lactate levels both before and 72 hours after surgery(P<0.05); The grading of the cistern at 4 hours postoperatively was only negatively correlated with the lactate level in cerebrospinal fluid at 72 hours postoperatively(P<0.01); There was a negative correlation(P<0.01) between the 72 hours postoperative grading of the cistern and the preoperative and 72 hours postoperative cerebrospinal fluid lactate levels.【Conclusion】 Preoperative evaluation of CT cistern grading in patients with severe head injury can reflect postoperative NICP levels and is closely related to preoperative cerebrospinal fluid lactate levels.
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Received: 26 October 2022
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2023, Vol. 40 
